Shapiro B A
Northwestern University Medical School, Chicago, Illinois, USA.
Acta Anaesthesiol Scand Suppl. 1995;104:69-74.
In vitro blood gas analysers inherently limit the frequency of serial blood gas measurements because of blood loss and cost. In vivo blood gas monitors eliminate an inherent cost and blood loss associated with measurement. Optode microsensing is a technology that can be readily adapted to in vivo measurement of pH, PCO2, and PO2. Optode-based intra-arterial devices that display continuous values have been developed that are practical for routine use but consistent performance remains a problem; an extra-arterial device that provides intermittent values has been shown to be consistent but is not yet available for routine use. The transfer of blood gas measurements from laboratory analysers to the combination of point-of-care analysers and monitors should have as profound an impact on acute respiratory care as did the introduction of laboratory-based blood gas analysers over 30 years ago. However, we must be sure these devices are reliable, consistent and cost beneficial in order to avoid widespread adoption of yet another technology that provides more data, more cost, and questionable patient benefit.
由于失血和成本问题,体外血气分析仪本质上限制了连续血气测量的频率。体内血气监测仪消除了与测量相关的固有成本和失血问题。光极微传感技术是一种可轻松应用于体内pH、PCO2和PO2测量的技术。已经开发出基于光极的动脉内装置,可显示连续值,适用于常规使用,但性能一致性仍是一个问题;一种提供间歇值的动脉外装置已被证明具有一致性,但尚未用于常规使用。血气测量从实验室分析仪向即时检验分析仪和监测仪组合的转变,对急性呼吸护理的影响应与30多年前引入基于实验室的血气分析仪一样深远。然而,我们必须确保这些设备可靠、一致且具有成本效益,以避免广泛采用另一种提供更多数据、更高成本且对患者益处存疑的技术。